A variety of devices and methods for grasping free suture portions or passing suture material through tissue are known in the art.
One method for passing a suture end through tissue involves attaching the suture end to a needle. The needle can then be passed through the tissue using a needle manipulating device. Once passed through the tissue, a separate device, known as a retrograder, may be employed to retrieve or otherwise manipulate the needle and suture.
In other methods, sharpened needle tips having suture grasping structures located within or near the needle tip may be used to grasp a suture, then penetrate the tissue to leave the suture end on the far side of the tissue where it can be grasped for further manipulation. Or, such a device may be used to penetrate the tissue first, grasp a suture on the far side of the tissue, and pull the suture back through the tissue.
The suture grasping elements employable in such devices can have various configurations. U.S. Pat. No. 5,569,269 discloses the use of two wire-like elements, one of which has a hook-shaped configuration. U.S. Pat. No. 5,496,335 discloses a suture grasping element having forcep jaws with sharpened tips. U.S. Pat. No. 5,501,692 discloses a suture grasping element in the form of a looped wire.
The known devices suffer from some drawbacks. In closed surgery, especially in arthroscopic surgery involving a joint such as a knee or shoulder, space and visibility constraints at the surgical site render it difficult to fully extend a suture grasping device to easily grasp a suture. Thus, it can be difficult to locate and grasp a portion of a suture during closed surgical procedures using the above described devices.
Also, because many of these devices have sharp edges that help to grasp the suture, there is a risk that the suture material will be cut while performing the desired suture manipulation at the surgical site. Likewise, some known suture grasper devices have grasping elements that can become caught or entangled in soft tissue during surgery. This entanglement, in turn, can lead to the permanent deformation of the grasping element and/or the unintentional damaging of tissue.